Peristaltically inflatable penile prosthetic

ABSTRACT

A penile prosthetic includes a proximal tip in communication with a reservoir, a cylinder bladder connected at a proximal end to the proximal tip and extending to a distal end, and peristaltic tubing disposed inside the cylinder bladder. The peristaltic tubing has a proximal end that communicates with the reservoir and a distal end that is open to the cylinder bladder. Peristaltic compression applied from the proximal end to the distal end of the peristaltic tubing pumps fluid from the reservoir into the cylinder bladder.

BACKGROUND

An implanted penile prosthetic is effective in relieving erectiledysfunction in men.

A penile prosthetic typically includes a cylinder that is implanted in acorpora cavernosum of the penis, a liquid reservoir implanted in theabdomen that communicates with the cylinder(s), and a pump located inthe scrotum that is employed to move liquid from the liquid reservoirinto the cylinder(s).

In a typical application, the user squeezes a bulb of the pump multipletimes to incrementally draw liquid out of the liquid reservoir, into thebulb, and eventually into the cylinders. The repeated squeezing of thebulb moves the liquid from the reservoir into the cylinders, whichincrementally deflates the reservoir and incrementally inflates thecylinder(s) to eventually provide the user with an erect penis. The usermay return the penis to its flaccid state by selectively transferringthe liquid from the cylinder(s) back into the reservoir.

The above-described penile prosthetics have proven effective inrelieving erectile dysfunction in men. However, surgeons and patientshave expressed a desire for improved penile prostheses.

SUMMARY

One aspect provides a single monolithic pump with a fluid reservoirintegrated in the pump, where the single monolithic pump/reservoir isimplantable into a corpora cavernosum of the penis to treat erectiledysfunction.

One aspect provides a penile prosthetic that includes a proximal tip incommunication with a reservoir, a cylinder bladder connected at aproximal end to the proximal tip and extending to a distal end, andperistaltic tubing disposed inside the cylinder bladder. The peristaltictubing has a proximal end that communicates with the reservoir and adistal end that is open to the cylinder bladder. Peristaltic compressionapplied from the proximal end to the distal end of the peristaltictubing pumps fluid from the reservoir into the cylinder bladder.

One aspect provides a method of treating erectile dysfunction. Themethod includes providing a pump having a proximal tip communicatingwith a fluid reservoir, a bladder connected at a proximal end to theproximal tip and extending to a closed distal end, and a tube disposedin the bladder, the tube having a proximal end in fluid communicationwith the fluid reservoir and a distal end that opens into the bladder.The method additionally includes implanting the pump into a corporacavernosum of a penis.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings are included to provide a furtherunderstanding of embodiments and are incorporated in and constitute apart of this specification. The drawings illustrate embodiments andtogether with the description serve to explain principles ofembodiments. Other embodiments and many of the intended advantages ofembodiments will be readily appreciated as they become better understoodby reference to the following detailed description. The elements of thedrawings are not necessarily to scale relative to each other. Likereference numerals designate corresponding similar parts.

FIG. 1 is a perspective view of one embodiment of a penile prostheticsystem including a pump that is implantable into a corpora cavernosum ofa penis, a reservoir implantable into an abdomen, and a check valveconnected between the pump and the reservoir.

FIG. 2 is a cross-sectional top view of the check valve illustrated inFIG. 1.

FIG. 3A is a cross-sectional side view of the check valve illustrated inFIG. 2 in a configuration that impedes fluid flow from the pump to thereservoir, and FIG. 3B is a cross-sectional side view of the check valvein a configuration that allows the fluid to flow from the pump to thereservoir.

FIG. 4 is a cross-sectional side view of one embodiment of the pumpillustrated in FIG. 1.

FIG. 5 is a cross-sectional side view of the pump illustrated in FIG. 4peristaltically compressed to drive the fluid into a bladder of thepump.

FIG. 6 is a cross-sectional side view of the pump illustrated in FIG. 5further peristaltically compressed to drive additional fluid into thebladder of the pump.

FIG. 7 is a cross-sectional side view of the pump illustrated in FIG. 4after peristaltic inflation of the bladder.

FIG. 8 is a schematic view of the penile prosthetic system illustratedin FIG. 1 with a pair of pumps implanted into the corpora cavernosa ofthe penis.

FIG. 9 is a cross-sectional side view of one embodiment of a pumpconfigured to be implanted into a corpora cavernosum of a penis.

FIG. 10 is a front view of a manifold that is disposed in a distal endportion of the pump illustrated in FIG. 9.

FIG. 11 is a cross-sectional side view of one embodiment of a penileimplant monolithically formed to include a peristaltic pump and a fluidreservoir that are both implantable into a single corpora cavernosum ofa penis.

FIG. 12 is a cross-sectional side view of the penile implant illustratedin FIG. 11 in an inflated state.

FIG. 13 is a cross-sectional side view of the penile implant illustratedin FIG. 11 in a deflated state.

DETAILED DESCRIPTION

In the following Detailed Description, reference is made to theaccompanying drawings, which form a part hereof, and in which is shownby way of illustration specific embodiments in which the invention maybe practiced. In this regard, directional terminology, such as “top,”“bottom,” “front,” “back,” “leading,” “trailing,” etc., is used withreference to the orientation of the Figure(s) being described. Becausecomponents of embodiments can be positioned in a number of differentorientations, the directional terminology is used for purposes ofillustration and is in no way limiting. It is to be understood thatother embodiments may be utilized and structural or logical changes maybe made without departing from the scope of the present invention. Thefollowing detailed description, therefore, is not to be taken in alimiting sense, and the scope of the present invention is defined by theappended claims.

It is to be understood that the features of the various exemplaryembodiments described herein may be combined with each other, unlessspecifically noted otherwise.

The term “proximal” as employed in this application means that thereferenced part is situated next to or near the point of attachment ororigin or a central point: as located toward a center of the human body.The term “distal” as employed in this application means that thereferenced part is situated away from the point of attachment or originor the central point: as located away from the center of the human body.A distal end is the furthest endmost location of a distal portion of athing being described, whereas a proximal end is the nearest endmostlocation of a proximal portion of the thing being described. Forexample, the glans penis is located distal, and of the crus of the penisis located proximal relative to the male body such that a distal end ofa corpora cavernosum of the patient extends about midway into the glanspenis.

“Fluid” means a non-solid substance that flows and includes gases andliquids, or a combination of a gas and a liquid.

“Gas” means a substance having molecules that disperse and are free toexpand to occupy an entire volume of a container in which it isdisposed. Air and methyl butane are two examples of gases.

“Liquid” means a substance having molecules that do not disperse suchthat the liquid resists compression and the molecules of the liquid willnot disperse to fill all spaces of a container in which the liquid isdisposed. Saline is an example of a liquid.

Atmospheric pressure at sea level is approximately 14 pounds per squareinch (PSI). The pressure measured or referred to as regards thepressurized liquid in the penile prosthetic assembly described herein isin reference to a gauge pressure, which is a pressure that has beenincreased above atmospheric pressure. This gauge pressure is recorded aspounds per square inch gauge (PSIg).

Peristaltic means a wavelike contraction of a tube or a tubularstructure between an entrance opening and an exit opening by whichcontents in the tube are forced to the exit opening. Peristalticcompression is a wavelike contraction that is provided, in one example,by pinching the tube with fingers (or a device) and sliding thefingers/device from near the entrance opening toward the exit opening.Peristaltic compression is referred to as a moving compression.

Embodiments provide a pump that is implanted into a corpora cavernosumof the penis, where the pump includes a bladder and a tube disposed inthe bladder. The tube is configured to peristaltically move fluid from areservoir into the bladder. In one embodiment, the reservoir isimplanted into the abdomen of the patient and the pump is implanted intothe corpora cavernosum of the penis. In one embodiment, a singlemonolithic pump with a fluid reservoir integrated inside the pump isimplantable into a corpora cavernosum of the penis. In variousembodiments, the patient uses his fingers to initiate a wavelikecontraction of the tube that peristaltically moves fluid from thereservoir into the bladder, thus inflating the bladder and creating anerection.

FIG. 1 is a perspective view of one embodiment of a penile prostheticsystem 20. The penile prosthetic system 20 (system 20) includes a fluidreservoir 22, a pair of penile prosthetic pumps 24, and a check valve 26connected between the fluid reservoir 22 and the penile prosthetic pumps24. In one embodiment, the penile prosthetic pumps 24 includes a firstprosthetic pump 24 a that is implantable into a first corpora cavernosumof the penis and a second prosthetic pump 24 b that is implantable intoa second corpora cavernosum of the penis. The reservoir 22 isimplantable in the body, for example within the abdomen of the user.Tubing 28 is connected between the fluid reservoir 22 and the checkvalve 26, and each of the prosthetic pumps 24 includes tubing 30connected to the check valve 26. Thus, the pumps 24 communicated withthe reservoir 22 via the tubing 28, 30.

FIG. 2 is a cross-sectional top view of one embodiment of the checkvalve 26. The check valve 26 includes a body 40, an inlet opening 42 andan outlet opening 44, and a ball 46 that is biased against a seat 48 bya spring 50. In one embodiment, the body 40 is a deformable body moldedor otherwise fabricated from a resilient/compressible polymer such assilicone or a thermoplastic polymer.

The check valve 26 is configured to allow fluid to be drawn from thereservoir 22 (FIG. 1) into the pumps 24 and impede or restrict the fluidfrom flowing out of the pumps 24 and back to the reservoir 22 until thisflow condition is selectively permitted by the user (as illustrated inFIG. 3A).

During an exemplary inflation of the pumps 24, the fluid is movedthrough the tubing 28 and the inlet opening 42 by a pumping condition ora pressure condition that moves the fluid out of the reservoir 22 with apressure sufficient to displace the ball 46 off of the seat 48. Thefluid moves through the outlet opening 44 and the tubing 30 and into thepenile prosthetic pumps 24 (FIG. 1).

FIG. 3A is a cross-sectional side view of the check valve 26illustrating that the fluid inside of the penile prosthetic pumps 24 isprevented from flowing back through the check valve 26 by the spring 50that biases the ball 46 against the seat 48. In this manner, the fluidemployed to inflate the pumps 24 (FIG. 1) maintains the pumps 24 in theinflated state until the user selectively manipulates the check valve 26to allow deflation of the pumps 24.

FIG. 3B is a cross-sectional side view of the check valve 26illustrating user-manipulation of the check valve 26 to allow deflationof the pumps 24. In one embodiment, the user-manipulation of the checkvalve 26 includes an application of a force F to deform the body 40.Deformation of the body 40 results in the ball 46 being displaced off ofthe seat 48, which allows the fluid to flow from the outlet opening 44past the ball 46 and back through the inlet opening 42 to the reservoir22 (FIG. 1).

FIG. 4 is a cross-sectional side view of one embodiment of the penileprosthetic pump 24. One of the penile prosthetic pumps 24 is describedwith the understanding that the typical application would include twoimplanted pumps 24, one in each of the two corpora cavernosa of thepatient.

The penile prosthetic pump 24 includes a proximal tip 60, a cylinderbladder 62 connected to the proximal tip 60, and peristaltic tubing 64disposed inside of the cylinder bladder 62. The penile prosthetic pump24 is illustrated with the cylinder bladder 62 offset from theperistaltic tubing 64 for improved descriptive clarity, although it isto be understood that a flaccid pump 24 (e.g., a pump 24 that is notfully inflated) would have the bladder 62 relaxed in a wrinkled orcrumpled state where the bladder 62 might even contact the peristaltictubing 64.

The proximal tip 60 communicates with the reservoir 22 (FIG. 1) via aconduit 70. In one embodiment, the proximal tip 60 is a substantiallysolid proximal tip that is formed to provide a chamber 72, with theconduit 70 extending from the chamber 72 to the reservoir 22 and theperistaltic tubing 64 communicating with and extending from the chamber72.

The cylinder bladder 62 extends from a proximal end of 74 that isconnected to the proximal tip 60 distally to a closed distal end 76. Inone embodiment, the cylinder bladder 62 is provided as a sealed andsubstantially enclosed bladder that defines a lumen, and the peristaltictubing 64 is disposed inside of the lumen.

The peristaltic tubing 64 has a proximal end 78 that is connected withthe chamber 72 and a distal end 80 that opens into the cylinder bladder62. In one embodiment, the peristaltic tubing 64 is a cantilevered tubewith the proximal end 78 connected to the proximal tip 60 and the distalend 80 free and unsupported, where the distal end 80 opens into thecylinder bladder 62. Peristaltic compression applied from the proximalend 78 toward the distal end 80 of the peristaltic tubing 64 pumps fluidfrom the reservoir 22 (FIG. 1) into the cylinder bladder 62.

In one embodiment, an optional rear tip extender 90 is provided that isattachable to a proximal end portion 92 of the proximal tip 60. Theoverall length of a penis includes an internal body portion located at aproximal end (termed the crus of the penis) to an external distal end(termed the glans penis). Naturally, the length of the penis differsbetween patients. The optional rear tip extender 90 is provided toextend the penile prosthetic pump 24 a greater distance in the proximaldirection, which allows the penile prosthetic to extend into the crus ofthe penis for an improved fit.

In one embodiment, the penile prosthetic 24 is substantially cylindricalor otherwise suited to be implantable into a corpora cavernosum of thepenis and includes the conduit 70 extending from the proximal tip 60,with the bladder 62 connected to the proximal tip 60, and theperistaltic tubing 64 is operable as a peristaltic pump and disposed inthe bladder 62. Sliding wave-like compression applied from the proximalend 78 to the distal end 80 of the peristaltic pump 64 moves the fluidfrom the fluid reservoir 22 into the bladder 62.

Suitable materials for fabricating the penile prosthetic pump 24 includepolymers, with two examples being polyurethane or silicone. For example,in one embodiment the bladder 62 is fabricated from a urethane materialsold under the trademark BIOFLEX available from Coloplast Corp.,Minneapolis, Minn. and the distal end 76 of the bladder 62 issubsequently dipped in additional urethane material that cures toprovide a desirable leading-end shape to the bladder 62. In oneembodiment, the bladder 62 is formed from silicone, which is dissimilarto urethane. To facilitate the attachment of these two dissimilarmaterials, in one embodiment the silicone bladder is coated with fumedsilica to prepare the surface for bonding with a urethane distal endtip.

FIG. 5 is a cross-sectional side view of the pump 24 peristalticallycompressed to draw fluid L from the reservoir 22 into the bladder 62 toinflate the penile prosthetic pump 24. In one embodiment, the usercompresses the bladder 62 and squeezes the walls of the peristaltictubing 64 together, and while squeezing the walls of the peristaltictubing 64, slides the compression from the proximal end 78 toward thedistal end 80 of the tubing 64. The moving compression of theperistaltic wave W suctions the fluid L from the reservoir 22, throughthe conduit 70, and passes the fluid L through the peristaltic tubing 64into the bladder 62. Subsequent, repeated moving compressions of theperistaltic wave W will drive more fluid L into the bladder 62

FIG. 6 is a cross-sectional side view of the pump 24 furtherperistaltically compressed to pass the fluid L into the bladder 62. Themoving compression has moved from the central section of the cylinderbladder 62 toward the distal end 76, thus moving the fluid L to the freeend 80 of the tubing 64 and ejecting the fluid L into the cylinderbladder 62. In one embodiment, the user is instructed by the surgeon toeject the fluid L out of the peristaltic tubing 64 into the cylinderbladder 62 until the bladder 62 is pressurized to about 10-20 PSIg.

FIG. 7 is a cross-sectional side view of the penile prosthetic pump 24fully inflated after application of peristaltic compression to theperistaltic tubing 64. The fluid L has been peristaltically pumped fromthe reservoir 22 through the peristaltic tubing 64 and into the cylinderbladder 62. The check valve 26 (FIG. 3A) impedes the flow of the fluid Lout of the cylinder bladder 62, which allows the penile prosthetic pump24 to maintain its inflation pressure until the user selectivelyactivates the check valve 26 to drain the fluid L from the cylinderbladder 62 back into the reservoir 22. In one embodiment, the fluid L inthe cylinder bladder 62 is pressurized to about 10-20 PSIg by thepumping of the peristaltic tubing 64.

FIG. 8 is a schematic view of the penile prosthetic system 20 with thereservoir implanted in the patient's abdomen and a prosthetic pump 24implanted into each corpora cavernosum of the penis P.

In one exemplary implantation approach, the groin area of the patient iscleaned, shaved, and suitably prepped with, for example, a surgicalsolution prior to draping with a sterile drape. A retraction device,such as a retractor sold under the trademark LONE STAR available fromLone Star Medical Products of Stafford, Tex., is placed around the penisP. Thereafter, the surgeon forms an incision to access the corporacavernosum of the patient, where suitable examples of incisions includeeither an infrapubic incision or a transverse scrotal incision.

The infrapubic incision is initiated between the umbilicus and the penis(i.e., above the penis), whereas the transverse scrotal incision is madeacross an upper portion of the patient's scrotum Sc. As an example ofthe transverse scrotal approach, the surgeon forms a 2-3 cm transverseincision through the subcutaneous tissue of the median raphe of theupper scrotum Sc and dissects down through the Dartos fascia and Buck'sfascia to expose the tunicae albuginea of the penis P.

Thereafter, each corpora cavernosum is exposed in a corporotomy where asmall (approximately 1.5 cm) incision is formed to allow the surgeon toaccess and dilate the corpora cavernosum. The corpora cavernosum isdilated distally toward the glans and proximally toward the crus with asuitable tool to create a space for the penile prosthetic pump 24. Forexample, the surgeon begins dilation of both the distal and proximalcorpora cavernosum by introducing an 8 mm dilator into the spongy tissueof the corpora with sequential progression to about a 14 mm dilator,each of which are introduced and pushed distally toward the glans penisand proximally toward the crus of the penis. The surgeon measures alength of the dilated corpora cavernosum to facilitate selection of theproper length of the penile prosthetic pump 24 and adjusts the length ofthe implant by adding an appropriately sized rear tip extender 90 (FIG.4) as desired.

After dilation of the corpora cavernosa, a deflated penile prostheticpump 24 (FIG. 4) is inserted into the prepared corporotomy. The surgeonmay palpate the end of penis P at the subcoronal area to locate thedistal end 76 of the penile prosthetic pump 24 to ensure proper interiorplacement of the prosthesis in the patient.

The reservoir 22 is connected to the penile prosthetic pump 24 via thetubing 28, 30 and the surgeon inflates and deflates the bladder 62 toensure proper function of the system 20. Thereafter, a reservoir 22filled with fluid L is implanted into the abdomen, for example in thespace of Retzius, and the surgical site is closed to allow the patientto heal.

During use, and with reference to FIGS. 5-7, the patient will applyperistaltic compression to the peristaltic tubing 64 from a locationadjacent to the proximal end 78 of the peristaltic tubing 64 toward thedistal end 80 of the peristaltic tubing 64 to draw fluid from thereservoir 22 into the cylinder bladder 62 to inflate the penis from aflaccid state to an erect state. The check valve 26 is configured toallow the fluid to flow from the reservoir 22 into the peristaltic pump24 implanted in the penis P to inflate the cylinder bladder 62. Thecheck valve 26 is configured as a one-way valve that impedes or preventsthe return flow of the fluid L from the peristaltic pump 24 back intothe reservoir 22 until the patient selectively and manually manipulatesthe check valve 26 to allow the return flow of the fluid.

The peristaltic pump 24 allows the patient improved control intransitioning the penis from its flaccid state to the erect state bymanually initiating a wavelike contraction in the peristaltic tubing 64.Other devices for treating erectile dysfunction include a bulb pump,often located in the scrotum Sc. Manually pumping the bulb pump can betiresome (especially for users with arthritis of the fingers), and hasthe potential to cause trauma to the skin of the scrotum Sc. Incontrast, the peristaltic pump 24 of system 20 provides a morenaturally-activated, controlled erection of the penis P.

FIG. 9 is a cross-sectional side view of one embodiment of a peristalticpump 100 suitable as an implantable penile prosthetic. In oneembodiment, the peristaltic pump 100 (pump 100) includes a proximal tip102 having a conduit 104 that communicates with the reservoir 22 (FIG.1), a cylinder bladder 106 attached to the proximal tip 102 andincluding a manifold 108, and peristaltic tubing 110 extending betweenthe proximal tip 102 and the manifold 108. The pump 100 is illustratedfor descriptive purposes in an inflated state with the fluid L fillingthe bladder 106 to an erect state.

The conduit 104 is similar to the conduit 70 (FIG. 4) and is provided astubing that is suitable for connection to the check valve 26 and thereservoir 22 illustrated in FIG. 1.

In one embodiment, the proximal tip 102 is formed to define a chamber112, with the peristaltic tubing 110 connected to the chamber 112 at aproximal end 114 and connected to the manifold 108 at a distal end 116.In this embodiment, the peristaltic tubing 110 is supported and securedon both of its opposing ends 114, 116.

In one embodiment, the bladder 106 is a resilient and flexible bladder(similar to the bladder 62 described above in FIG. 4) and is configuredto be inflated and deflated by a fluid that is pumped through theperistaltic tubing 110 into the manifold 108 to fill and inflate thebladder 106. The bladder 106 is suitably attached to the proximal tip102 by adhesive, molding, sonic welding or other suitable attachmentapproaches for connecting two polymeric materials.

FIG. 10 is a front view of the manifold 108 as disposed in a distal endportion 118 of the bladder 106. In one embodiment, the manifold 108includes a central collector channel 120 that extends from the distalend 116 of the peristaltic the tubing 110 to communicate with one ormore radial channels 122 that communicate between the central collectorchannel 120 and the cylinder bladder 106.

In one embodiment, the manifold 108 is provided as a relatively “soft”polymer, such as silicone with a durometer of less than about 30 ShoreA, selected to provide a suitable soft and dexterous feel at the distalend portion 118 of the bladder 106. In one embodiment, the manifold 108is provided as a firmer polymer, such as silicone with a durometer ofmore than about 30 Shore A, which provides a firmer tip at the distalend portion 118 of the bladder 106.

In one embodiment, the manifold 108 is formed to include one channel 122that directs the fluid L from the peristaltic tubing 110 into thebladder 106. In one embodiment, the manifold 108 is formed to includemultiple “shower head” channels 122 that direct the fluid L from theperistaltic tubing 110 into the bladder 106.

FIG. 11 is a cross-sectional side view of one embodiment of a penileimplant 200 including a peristaltic pump 202 and a fluid reservoir 204that are both implantable into a single corpora cavernosum of a penis.In contrast to multi-component penile prosthetics that provide a fluidreservoir (usually implanted in the abdomen) separate from a fluid pump(usually implanted in the scrotum) with both the pump and the reservoirseparate from the penile cylinders, the penile prosthetic implant 200provides a single monolithic implant that includes the pump 202, thereservoir 204, and a girth-expanding bladder 216 all integrated into onedevice that is implantable into a corpora cavernosum of the penis.

In one embodiment, the peristaltic pump 202 (pump 202) includes aproximal tip 212 integrally formed to include the reservoir 204, acylinder bladder 216 attached to the proximal tip 212 and including amanifold 218, and peristaltic tubing 220 extending between the proximaltip 212 and the manifold 218. The pump 202 is illustrated fordescriptive purposes in a deflated state with a portion L1 of the totalfluid volume of the implant 200 retained in the fluid reservoir 204 anda portion L2 of the total fluid volume of the implant 200 retained inthe bladder 216. The peristaltic tubing 220 is operable to displace theportion L1 of the fluid retained in the fluid reservoir 204 into thebladder 216 so that the bladder 216 is inflated/pressurized by thecombination of the fluid portion L1 and the fluid portion L2.

In one embodiment, the bladder 216 is a resilient and flexible bladdersimilar to the bladders described above and is configured to be inflatedby pumping fluid through the peristaltic tubing 220 and the manifold 218to fill and inflate the bladder 216. The bladder 216 is suitablyattached to the proximal tip 212 by adhesive, molding, sonic welding orother suitable attachment approaches for connecting two polymericmaterials.

In one embodiment, the manifold 218 is similar to the manifold 108described above and includes a central collector channel 230 thatextends from a distal end 232 of the peristaltic the tubing 220 tocommunicate with one or more radial channels 234 that communicatebetween the central collector channel 230 and the cylinder bladder 216.The fluid L1 that is pumped through the peristaltic tubing 220 issprayed or distributed by the radial channels 234 into the bladder 216.

In one embodiment, the proximal tip 212 houses the reservoir 204 and acheck valve assembly 240 that is disposed between the fluid reservoir204 and the penile pump 202. The check valve assembly 240 is operable toseparate the fluid L1 in the reservoir 204 from the fluid L2 in thebladder 216 when the pump 202 is in a deflated state. In addition, thecheck valve assembly 240 is operable by the user to selectively todeflate the bladder 216 by allowing the fluid L1 that is pumped into thebladder 216 to be returned into the reservoir 204.

In one embodiment, the proximal tip 212 is fabricated from stainlesssteel to provide a housing for the reservoir 204 and the check valveassembly 240.

In one embodiment, the check valve assembly 240 includes a ball 250 thatis biased against a seat 252 by a spring 254 and a deflation mechanism256 that is operable to displace the ball 250 off of the seat 252. Inone embodiment, the deflation mechanism 256 is provided as a flexibleplunger cable 256 including a plunger rod 260 retained within a cable258 and biased in a spring-loaded manner by a spring 262. The plungerrod 260 is movable to displace the ball 250 off of the seat 252. Inaddition, the plunger rod is biased by the spring 262 to allow the ball250 to remain on the seat 252 until the user selectively decides todeflate the bladder 216.

In one embodiment, the deflation mechanism 256 is provided as a flexiblecable that is sized and configured for placement within the patient'sscrotum. In other embodiments, the deflation mechanism 256 is suitablyimplanted in the abdomen or another body cavity of the patient. In oneembodiment, the deflation mechanism 256 is surgically implanted withinthe patient's scrotum and connected to the monolithic unit of the pump202 and the reservoir 204 that are both implanted within a corporacavernosum of the penis.

FIG. 12 is a cross-sectional side view of the penile implant 200 in aninflated state and FIG. 13 is a cross-sectional side view of the penileprosthetic implant 200 in a deflated state.

FIG. 12 is a cross-sectional view of the penile implant 200 after theperistaltic tubing 220 has been peristaltically pumped to transfer thefluid L1 from the reservoir 204 into the bladder 216. The peristalticpumping (See FIGS. 5 and 6) of the peristaltic tubing 220 suctions ordraws the fluid L1 from the reservoir 204 with a sufficient pressure tocompress the spring 254 and displace the ball 250 off of the seat 252,which results in the fluid L1 moving through the peristaltic tubing 220into the bladder 216. The fluid portion L1 mixes with the fluid portionL2 to inflate the bladder 216 to a pressure of about 15 PSIg. The fluidin the bladder 216 is prevented from flowing back into the reservoir 200by the ball 250 that is seated against the seat 252.

The portion of fluid L1 in addition to the portion of fluid L2 combineto provide a total volume of liquid that is selected to completelyinflate the bladder 216. In one embodiment, the portion of fluid L1 hasa volume of about 150 mL and the portion of fluid L2 as a volume ofabout 100 mL.

FIG. 13 is a cross-sectional side view of the penile prosthetic implant208 in a deflated state. The plunger rod 260 has been pressed todisplace the ball 250 off seat of the seat 252. A portion of the fluidL1 inside of the bladder 216 flows past the seat 252 and back into thereservoir 204, deflating the bladder 216. The user may assist thedeflation of the bladder 216 by squeezing the bladder 216 whileactivating the plunger at 260. The plunger rod 260 is biased back intoits stable configuration when deactivated by the user, allowing the ball250 to return to the seat 252.

Embodiments provide a pump that is implanted into a corpora cavernosumof the penis, where the pump includes a peristaltic tube. The patientuses his fingers to initiate a wavelike contraction of the tube thatperistaltically moves fluid from a reservoir into a bladder of the pump,thus inflating the bladder and creating an erection.

Although specific embodiments have been illustrated and describedherein, it will be appreciated by those of ordinary skill in the artthat a variety of alternate and/or equivalent implementations may besubstituted for the specific embodiments shown and described withoutdeparting from the scope of the present invention. This application isintended to cover any adaptations or variations of medical devices asdiscussed herein. Therefore, it is intended that this invention belimited only by the claims and the equivalents thereof.

What is claimed is:
 1. A penile prosthetic system comprising: areservoir; a bladder attachable to communicate with the reservoir;tubing disposed inside the bladder, the tubing having one end thatcommunicates with the reservoir and a second end that opens into thebladder; and a check valve connected between the reservoir and thetubing, the check valve configured to allow fluid to be drawn from thereservoir into the tubing and restrict the fluid from flowing out of thetubing and back to the reservoir.
 2. The penile prosthetic system ofclaim 1, further comprising a manifold disposed at a distal end portionof the bladder, the manifold defining at least one channel extendingfrom a distal end of the tubing to the bladder.
 3. The penile prostheticsystem of claim 1, wherein the bladder is provided as a sealed andsubstantially enclosed lumen and the tubing is peristaltic tubing isdisposed inside the sealed and substantially enclosed lumen.
 4. Thepenile prosthetic system of claim 1, wherein the tubing is cantileveredwith a proximal end of the tube connected to a proximal tip of thepenile prosthetic and a distal end of the tube is a free end.
 5. Apenile prosthetic that is inflatable with fluid contained in areservoir, the penile prosthetic comprising: a bladder and a tubedisposed inside the bladder, the tube having a proximal end thatcommunicates with the reservoir and a distal end that opens into thebladder; and a check valve connected between the reservoir and the tube,the check valve configured to allow liquid to be drawn from thereservoir into the tube and restrict the liquid from flowing out of thetube and back to the reservoir; wherein the tube is configured to pumpthe liquid from the reservoir in response to compression applied fromthe proximal end of the tube to the distal end of the tube.
 6. Thepenile prosthetic of claim 5, further comprising: a manifold disposed ina distal end portion of the bladder, the manifold having a channelcommunicating between the distal end of the tube and the bladder.
 7. Thepenile prosthetic of claim 6, wherein the proximal end of the tube isconnected to a proximal tip of the penile prosthetic and the distal endof the tube is connected to the manifold.